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Prophylactic infusion of norepinephrine does not affect the rostral spread of spinal anesthesia in pregnancy: a prospective, randomized, double-blinded study.

作者信息

Dong Yu-Fang, Qian Jing, Wang Jing, Wang Li-Zhong, Qian Xing-Hua, Xiao Fei

机构信息

Department of Anesthesia, Jiaxing University Affiliated Women and Children Hospital, Jiaxing, China.

出版信息

Front Pharmacol. 2024 Jan 9;14:1340452. doi: 10.3389/fphar.2023.1340452. eCollection 2023.


DOI:10.3389/fphar.2023.1340452
PMID:38264521
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10803475/
Abstract

The infusion of phenylephrine to prevent spinal-induced hypotension (SIH) in cesarean delivery may decrease the rostral spread of a spinal local anesthetic. We hypothesized that infusion of norepinephrine may decrease the rostral spread of spinal anesthesia, similar to that caused by phenylephrine. The aim of this study was to compare the block height of spinal anesthesia in the presence or absence of norepinephrine infusion administered to prevent SIH during cesarean delivery. Eighty patients were enrolled and allocated into groups receiving a norepinephrine infusion (group N) or saline infusion (group C). After intrathecal injection of hyperbaric bupivacaine 10 mg, the block height for cold and pinprick sensation was checked 10 and 20 min after the injection. The demographic characteristics, spinal anesthesia, side effects, and neonatal outcomes were also recorded. The block height for cold and pinprick sensation was similar between the two groups, although the incidence of hypotension was significantly lower ( 0.00) in group N than in group C. Systolic blood pressure was also more stable in group N than in group C, with the incidence of interventions being significantly lower in group N. There was no significant difference in patient satisfaction between the two groups. Evidence from this study suggested that prophylactic norepinephrine infusion does not reduce the rostral spread of spinal anesthesia in pregnancy. We suggest that it is not necessary to increase the dose of an intrathecal local anesthetic for cesarean delivery when prophylactic norepinephrine is administered. : https://www.chictr.org.cn/bin/project/edit?pid=152899, identifier [ChiCTR2200057439].

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/759a/10803475/bfdd15a7e219/fphar-14-1340452-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/759a/10803475/868fe5ceb80a/fphar-14-1340452-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/759a/10803475/f8545d274460/fphar-14-1340452-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/759a/10803475/bfdd15a7e219/fphar-14-1340452-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/759a/10803475/868fe5ceb80a/fphar-14-1340452-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/759a/10803475/f8545d274460/fphar-14-1340452-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/759a/10803475/bfdd15a7e219/fphar-14-1340452-g003.jpg

相似文献

[1]
Prophylactic infusion of norepinephrine does not affect the rostral spread of spinal anesthesia in pregnancy: a prospective, randomized, double-blinded study.

Front Pharmacol. 2024-1-9

[2]
Comparative study on the manually-controlled variable-rate versus fixed-rate infusion of norepinephrine for preventing hypotension during spinal anesthesia for cesarean delivery.

J Clin Anesth. 2022-11

[3]
Minimum effective dose of intrathecal hyperbaric bupivacaine for cesarean section with and without prophylactic norepinephrine infusion: Randomized triple-blinded trial.

J Anaesthesiol Clin Pharmacol. 2024

[4]
Prophylactic infusion of phenylephrine increases the median effective dose of intrathecal hyperbaric bupivacaine in cesarean section: A prospective randomized study.

Medicine (Baltimore). 2018-8

[5]
Comparison of the ED50 and ED95 of Intrathecal Bupivacaine in Parturients Undergoing Cesarean Delivery With or Without Prophylactic Phenylephrine Infusion: A Prospective, Double-Blind Study.

Reg Anesth Pain Med. 2018-11

[6]
[Effective Dose of Prophylactic Norepinephrine for Preventing Hypotension under Combined Spinal and Epidural Anesthesia during Cesarean Section in Singleton Versus Twin Pregnancies].

Sichuan Da Xue Xue Bao Yi Xue Ban. 2022-9

[7]
Dose-Response Study of 4 Weight-Based Phenylephrine Infusion Regimens for Preventing Hypotension During Cesarean Delivery Under Combined Spinal-Epidural Anesthesia.

Anesth Analg. 2020-1

[8]
The ED and ED of Prophylactic Norepinephrine for Preventing Post-Spinal Hypotension During Cesarean Delivery Under Combined Spinal-Epidural Anesthesia: A Prospective Dose-Finding Study.

Front Pharmacol. 2021-7-12

[9]
ED50 of intrathecal ropivacaine for cesarean section under prophylactic infusion of phenylephrine: A consort study.

Medicine (Baltimore). 2017-11

[10]
Evidence that intravenous vasopressors can affect rostral spread of spinal anesthesia in pregnancy.

Anesthesiology. 2004-7

本文引用的文献

[1]
Determination of the Relative Potency of Norepinephrine and Phenylephrine Given as Infusions for Preventing Hypotension During Combined Spinal-Epidural Anesthesia for Cesarean Delivery: A Randomized Up-And-Down Sequential Allocation Study.

Front Pharmacol. 2022-7-14

[2]
Neonatal outcomes following phenylephrine or norepinephrine for treatment of spinal anaesthesia-induced hypotension at emergency caesarean section in women with fetal compromise: a randomised controlled study.

Int J Obstet Anesth. 2022-2

[3]
The ED and ED of Prophylactic Norepinephrine for Preventing Post-Spinal Hypotension During Cesarean Delivery Under Combined Spinal-Epidural Anesthesia: A Prospective Dose-Finding Study.

Front Pharmacol. 2021-7-12

[4]
Prevention of hypotension during elective cesarean section with a fixed-rate norepinephrine infusion versus a fixed-rate phenylephrine infusion. Α double-blinded randomized controlled trial.

Int J Surg. 2020-12

[5]
Risk of Major Complications After Perioperative Norepinephrine Infusion Through Peripheral Intravenous Lines in a Multicenter Study.

Anesth Analg. 2020-10

[6]
Norepinephrine or phenylephrine during spinal anaesthesia for Caesarean delivery: a randomised double-blind pragmatic non-inferiority study of neonatal outcome.

Br J Anaesth. 2020-7-15

[7]
Techniques for preventing hypotension during spinal anaesthesia for caesarean section.

Cochrane Database Syst Rev. 2020-7-1

[8]
Hypotension after spinal anesthesia for cesarean section: how to approach the iatrogenic sympathectomy.

Curr Opin Anaesthesiol. 2020-6

[9]
Norepinephrine for the prevention of spinal-induced hypotension during caesarean delivery under combined spinal-epidural anaesthesia: Randomised, double-blind, dose-finding study.

Eur J Anaesthesiol. 2020-4

[10]
A randomised double-blind dose-response study of weight-adjusted infusions of norepinephrine for preventing hypotension during combined spinal-epidural anaesthesia for Caesarean delivery.

Br J Anaesth. 2020-1-17

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